Direct oral anticoagulants in adults with congenital heart disease – a single centre study

Pujol, C.; Müssigmann, Mara; Schiele, Sandra; Nagdyman, Nicole; Niesert, Anne‐Charlotte; Kaemmerer, Harald; Ewert, Peter; Tutarel, Oktay

doi:10.1016/j.ijcard.2019.09.077

Cited by 20 publications

(18 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pujol et al [ 29 ] examined the use of NOACs in 215 ACHD patients. In this cohort, 44% of the total population had complex CHD, including 12 patients (5.6%) with a Fontan circulation, and 17 patients (7.9%) with chronic cyanosis.…”

Section: Resultsmentioning

confidence: 99%

Non-Vitamin K Oral Anticoagulants in Adults with Congenital Heart Disease: A Systematic Review

Stalikas

Doundoulakis

Karagiannidis

et al. 2020

JCM

View full text Add to dashboard Cite

Adults with congenital heart disease (ACHD) experience more thromboembolic complications than the general population. We systematically searched and critically appraised all studies on the safety and efficacy of non-vitamin-K oral anticoagulants (NOACs) in adult patients with various forms of congenital heart disease. PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) were used, with duplicate extraction of data and risk of bias assessment. The Newcastle-Ottawa quality assessment scale was used to assess study quality. Three studies fulfilled the inclusion criteria and were analyzed. The total number of participants was 766, with a total follow-up of 923 patient-years. The majority of patients (77%) received a NOAC for atrial arrhythmias, while the remainder were prescribed NOACs for secondary (19%) or primary (4%) thromboprophylaxis. The annual rate of thromboembolic and major bleeding events was low: 0.98% (95% CI: 0.51–1.86) and 1.74% (95% CI: 0.86–3.49) respectively. In Fontan patients, the annual rate of thromboembolic and major bleeding events was 3.13% (95% CI: 1.18–8.03) and 3.17% (95% CI: 0.15–41.39) respectively. NOACs appear safe and effective in ACHD without mechanical prostheses. Additional studies are, however, needed to confirm their efficacy in complex ACHD, especially those with a Fontan-type circulation.

show abstract

Section: Resultsmentioning

confidence: 99%

Non-Vitamin K Oral Anticoagulants in Adults with Congenital Heart Disease: A Systematic Review

Stalikas

Doundoulakis

Karagiannidis

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…As a result it is suggested that cyanotic patients should receive OAC therapy if they have an arrhythmia with most commonly AF (14,21). In two recent single-and multicenter studies (with a majority of patients with moderate or complex severity), treatment with a NOAC was not associated with an increased risk as long as the patients did not have an impaired renal function (22,23).…”

Section: Stroke Risk Assessment Using the Ch A 2d S 2-vasc Score In Achd Patientsmentioning

confidence: 99%

“…Therefore, the current guidelines most commonly endorse the use of VKA in ACHD patients (1,14). However, the current status regarding the use of NOACs has to be reassessed in light of new study results and publications specifically addressing this issue in ACHD patients (1,14,16,(21)(22)(23)(27)(28)(29)(30)(31)(32)(33)(34). The current recommendations as covered by the guidelines summarized in Figure 2.…”

Section: The Use Of Novel Oral Anticoagulants (Noac) In Achd Patientsmentioning

confidence: 99%

“…Some observational studies have reported on the use of NOACs in ACHD. These include a larger single-centre study (23,27) and the worldwide NOTE registry (22). In both studies (22,23) the majority of ACHD patients was of moderate or severe complexity.…”

Section: The Use Of Novel Oral Anticoagulants (Noac) In Achd Patientsmentioning

confidence: 99%

“…These include a larger single-centre study (23,27) and the worldwide NOTE registry (22). In both studies (22,23) the majority of ACHD patients was of moderate or severe complexity. Therefore, these reports address the knowledge gap regarding these patient cohorts including patients with Fontan circulation or arrhythmias in need of anticoagulation (1).…”

Section: The Use Of Novel Oral Anticoagulants (Noac) In Achd Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Anticoagulation management in adult patients with congenital heart disease: a narrative review

Sinning¹,

Zengin²,

Blankenberg³

et al. 2021

Cardiovasc Diagn Ther

View full text Add to dashboard Cite

With improvements in treatment of congenital heart disease more paediatric patients are surviving with palliative or corrective interventions during childhood, thus becoming adults with congenital heart disease (ACHD). Overall, the ACHD population is at a higher risk of arrhythmias and stroke. The abnormal structure and function of their corrected hearts suggests that in addition to established stroke risk factors, such as prior stroke or older age, additional stroke risk factors need to be considered to determine the risk and establish the indication for oral anticoagulation (OAC) in ACHD patients. In structurally normal hearts non-vitamin-K oral anticoagulants (NOACs) offer at least equal stroke prevention with a better safety profile compared to vitamin K antagonists (VKA) in patients with atrial fibrillation (AF) or pulmonary embolism. Current guidelines recommend NOACs in ACHD patients with simple lesions and indication for OAC, while there is less certainty about their safety in ACHD patients with moderate or complex congenital heart disease such as patients with transposition of the great arteries (TGA) after atrial switch operation (Senning or Mustard operation), Fontan circulation or congenital corrected transposition of the great arteries (ccTGA). This review summarises the available evidence characterising stroke risk in patients with ACHD and the use of anticoagulants and interventional therapies to reduce that risk.

show abstract

A Multisite Retrospective Review of Direct Oral Anticoagulants Compared to Warfarin in Adult Fontan Patients

Kazerouninia

Georgekutty

Kendsersky

et al. 2022

Cardiovasc Drugs Ther

View full text Add to dashboard Cite

Direct oral anticoagulants in adults with congenital heart disease – a single centre study

Cited by 20 publications

References 20 publications

Non-Vitamin K Oral Anticoagulants in Adults with Congenital Heart Disease: A Systematic Review

Non-Vitamin K Oral Anticoagulants in Adults with Congenital Heart Disease: A Systematic Review

Anticoagulation management in adult patients with congenital heart disease: a narrative review

A Multisite Retrospective Review of Direct Oral Anticoagulants Compared to Warfarin in Adult Fontan Patients

Contact Info

Product

Resources

About